NCLEX RN Quiz # 103

NCLEX Examination.

Practice Question # 103.

Uses of Heparin:

Prophylaxis and treatment of thromboembolic disorders; anticoagulant for extracorporeal and dialysis procedures; maintain patency of IV devices. STEMI, non-STEMI, unstable angina, anticoagulant used during percutaneous coronary intervention.

PRECAUTIONS

Contraindications: Severe thrombocytopenia, uncontrolled active bleeding (unless secondary to DIC) Cautions:  Allergy to pork. Pts at risk for bleeding (e.g., congenital/acquired bleeding disorders, active GI ulcerative disease, hemophilia, concomitant platelet inhibitors); pts with history of heparin-induced thrombocytopenia.

ACTION

Interferes with blood coagulation by blocking conversion of prothrombin to thrombin and fibrinogen to fibrin. Therapeutic Effect: Prevents further extension of existing thrombi or new clot formation. No effect on existing clots.

PHARMACOKINETICS

Well absorbed following subcutaneous administration. Protein binding: Very high. Metabolized in liver. Removed from circulation via uptake by reticuloendothelial system. Primarily excreted in urine. Not removed by hemodialysis. Half-life: 1–6 hrs.  LIFESPAN CONSIDERATIONS

Pregnancy/Lactation: Use with caution, particularly during last trimester, immediate postpartum period (increased risk of maternal hemorrhage). Does not cross placenta. Not distributed in breast milk.

Pregnancy Category C. Children:  No age-related precautions noted. Benzyl alcohol preservative may cause gasping syndrome in infants. Elderly: More susceptible to hemorrhage. Age-related renal impairment may increase risk of bleeding.

INTERACTIONS

DRUG:  Other anticoagulants, platelet aggregation inhibitors, thrombolytics may increase risk of bleeding.

HERBAL:  Cat’s claw, dong quai, evening primrose, feverfew, garlic, ginkgo, ginseng, horse chestnut, red clover have additional antiplatelet activity.

FOOD: None known. LAB VALUES: May increase free fatty acids, serum ALT, AST; aPTT. May decrease serum cholesterol.